title: Subintimal distal anchor technique for "balloon-uncrossable" chronic total occlusions.
abstract: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) presents unique challenges and potential complications. The two most common failure modes are inability to cross the lesion with a guidewire and failure to cross the CTO with a balloon after successful guidewire crossing ("balloon-uncrossable" CTO). We present a creative solution to assist crossing of balloon-uncrossable CTOs that entails use of a balloon placed over a wire that has been advanced though the subintimal space to "anchor" the guidewire that has crossed through the CTO true lumen enabling lesion crossing with a balloon.
authors.affiliation: Dallas VA Medical Center (111A), 4500 South Lancaster Road, Dallas, TX 75216 USA. esbrilakis@gmail.com.
authors.forename: Tesfaldet T
authors.initials: TT
authors.lastname: Michael
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D002908:Chronic Disease; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011859:Radiography; D017539:Tunica Intima